Merck’s Shingles Vaccine Not Reaching Enough U.S. Adults

Too few American adults have been vaccinated for shingles, the painful sibling to chicken pox, according to research that calls for efforts to increase the U.S.-recommended inoculation.

Fewer than 2 of 10 Americans ages 60 and older have been vaccinated, while the rate is less than half that for those in their 50s, according to a study presented today at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy in Denver.

Almost one-third of Americans will get shingles in their lifetime, with about 1 million cases in the U.S. each year, the Centers for Disease Control and Prevention said. The vaccine Zostavax, from Merck & Co., was cleared for sale in 2006 for people 60 and older, and for use by those in their 50s in 2011. Still, too few people take advantage of it, doctors said.

“It’s a good idea if you’re older than 50 to go to your doctor and have that discussion about when you should receive your vaccine,” Melissa Johnson, an associate professor at Duke University Medical Center in Durham, North Carolina, said today in a presentation at the conference. “This is a conversation we should all be having with our family members.”

Shingles is caused by the same virus as chicken pox; it can remain in the body after a chicken pox infection and become active again years later. It’s characterized by a painful rash that generally clears within a month and can be accompanied by fever, stomach ache and chills.

A more problematic lasting side effect is postherpetic neuralgia, a burning nerve pain that can be severe enough to disrupt sleep and affect appetite, according to the Mayo Clinic. Good treatments for the pain don’t exist, Johnson said.

High Cost

Shingles costs the U.S. health system at least $1 billion each year, through a combination of doctor visits, medications and missed work, she said.

“This is a potential area where we can do cost avoidance,” Johnson said. Patients can “get Zostavax as part of routine coverage.”

Shingles becomes more prevalent with age; about half of infections occur in those 60 and older, according to the CDC. Yet just 16 percent of Americans in that age group had been vaccinated in 2011, the study of almost 30,000 people found. That compares with 4.3 percent of U.S. adults in their 50s.

The Food and Drug Administration approved the vaccine in the younger set after research showed it helped reduce the risk of shingles by 70 percent compared with placebo, according to an agency statement.

Zostavax Revenue

Zostavax generated $651 million in 2012 revenue for the Whitehouse Station, New Jersey-based drugmaker, up 96 percent from $332 million the year before, according to the company’s annual report. Analysts estimate it will generate more than $1 billion in 2014.

Merck focuses on getting the vaccine to those 60 and older, following guidelines from CDC’s Advisory Committee on Immunization Practices, Pam Eisele, a company spokeswoman, said in an e-mail. Increased availability of the vaccine in pharmacies could help with accessibility, Eisele said.

The vaccine is generally covered by insurers for people 60 and older, researchers said today. For younger people whose insurance doesn’t cover it, the vaccine may cost about $200 out of pocket, Johnson said.

“We feel that the cost of the vaccine is justified by preventing all the complications that occur if you do develop shingles,” she said.

“I’d eliminate my coffee in the morning to afford that,” said Michael Schmidt, professor and vice chairman of microbiology and immunology at Medical University of South Carolina, who moderated Johnson’s presentation. “This is one of these high-value topics. At $200, it’s cheap at twice the price.”

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